A simple grafting method to repair irreparable distal biceps tendon

Irreparable distal biceps tendon tears typically are treated using a free tendon graft. We asked whether our new method to fix the graft--using two suture anchors--yields similar results to our previous bone canal method. We compared the two methods for strength, endurance, and clinical findings. There were two groups, the suture anchor group (Group A, seven patients) and the bone canal group operated on before suture anchors (Group B, seven patients). The patients were males with a mean age at surgery of 44.9 years. The operative delay from primary trauma to index surgery averaged 5.9 months. The minimum followup was 2 years (mean, 11.1 years; range, 2-23 years). The mean arc of elbow motion was 0 degrees to 132 degrees, pronation 83 degrees, and supination 80 degrees. Compared with the contralateral side, the maximal peak torque was 84% in supination and 91% in pronation, and the maximal static elbow flexion strength was 94%. The Mayo elbow score averaged 99 in Group A and 100 in Group B. There were no major differences between the two groups. Our novel modification to fix a tendon graft yields equal clinical outcomes compared with the bone canal method for treatment of irreparable distal biceps tendon injuries.

Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.